Otimização de Configuração de Estruturas Reticuladas

A presente dissertação tem como principal objetivo explorar a capacidade do programa PROAES calcular as derivadas das funções objetivo e constrangimento em relação a variáveis de configuração para resolver exemplos que combinam simultaneamente otimização de con- figuração e otimização topológica ou robusta de estruturas reticuladas. A otimização de configuração de estruturas reticuladas constituídas por barras está as- sociada à seleção mais adequada da orientação do eixo de cada um dos elementos na estru- tura e, num modelo de elementos finitos, as variáveis de configuração permitem modificar a orientação no espaço dos referenciais locais dos respetivos elementos estruturais. Este tipo de solução para otimizar o desempenho das estruturas, torna-se particularmente interessante quando combinada com otimização topológica, que permite que seja adicionado ou removido material dentro de um domínio de projeto, o que significa que quando ambas as otimizações se combinam surgem resultados bastante interessantes. A combinação foi também efetuada conjuntamente com otimização baseada em incerteza, de forma a enriquecer o estudo. De forma a testar a aplicabilidade destes conceitos de otimização simultaneamente, bem como averiguar as potencialidades das metodologias criadas, foram realizados diferentes tes- tes em estruturas compostas por elementos barra 2D e 3D recorrendo a casos de estudo refe- renciados na bibliografia, tendo sido criado um caso de estudo de raiz. Os resultados obtidos revelam um bom desempenho do programa e validam as metodologias utilizadas.The main objective of this dissertation is to explore the capabilities of the PROAES Pro- gram to calculate the gradients of objective and constraint functions with regard to configura- tion design variables to solve problems that involve simultaneously, Shape Optimization, To- pology Optimization and Robust Optimization. Shape Optimization of Truss Structures is associated with the most accurate selection of the axis of every single one of the elements that are part of the Truss Structure. That is con- nected with shape variables, which happen every time that the space orientation of local refe- rentials of the finite elements are modified. This type of solution, which has the objective of improving structural performance, is particularly interesting when combined with Topology Optimization. This later method allows material to be added or removed from the initial struc- ture within the project boundaries, which means that when the two types of Optimization are combined the potential results of the final structure are very interesting. It was also tested the possibility of combination with methods that regard uncertainty considerations in order to have a richer content in this study. In order to test the applicability of these concepts simultaneously as well as to test the potential results of the created methodologies some tests in 2D and 3D Truss Structures were developed from previous studies obtained in the literature and another case study was fully created. The results obtained show a good performance of the program and validate the used and developed methodologies

Evaluation of durability and resistance of steel anchorages in masonry walls

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Mudanças na vida quotidiana em pessoas idosas institucionalizadas pelo impacto da doença

Objective: To verify the changes in daily life in institutionalized older adults caused by the impact of the disease, was the general objective of this ethnographic research. Method: The study was carried out with 99 residents of a long-term care institution for the elderly in southern Brazil. There was documentary research of the Institution and the permanence of the researcher to familiarize him with the environment and the entire public. Participant observation and semi-structured interviews were used for data collection. After the fieldwork, the data were analyzed through the description of the observation and the hermeneutic-dialectic method. Results: The results showed functional dependence, loss of autonomy, and personal control. Based on the participants’ comments, the study detected a lack of freedom, physical dependence to carry out routine activities, occupation reduction, isolation, and difficulty to sleep. The impairment of mobility was noted in the participant observation and the interviews. Conclusion: In the final remarks, the issue of qualitative research highlights the restriction of autonomy that older people are residing in the Institution in the face of the new conditions experienced in institutional life caused by the disease, which interferes with the quality of life of these residents.Objetivo: Verificar as mudanças na vida cotidiana em pessoas idosas institucionalizadas provocadas pelo impacto da doença foi o objetivo geral desta pesquisa etnográfica. Método: A pesquisa decorreu com 99 residentes de uma instituição de longa permanência para idosos, no sul do Brasil. Houve uma pesquisa documental da Instituição e a permanência do pesquisador para a familiarização deste com o ambiente e todo o público. A observação participante e a entrevista semiestruturada foram utilizadas para a coleta de dados. Após o trabalho de campo, os dados foram analisados por meio da descrição da observação e pelo método hermenêutico-dialético. Resultados: observou-se a dependência funcional, perda da autonomia e do controle pessoal. Nas falas dos participantes, constatou-se a perda da liberdade, a dependência física nas atividades do cotidiano, a diminuição da ocupação, o isolamento e a dificuldade para dormir. O acometimento da mobilidade foi notado na observação participante e nas entrevistas. Conclusão: Nas considerações finais a temática da pesquisa qualitativa destaca a restrição da autonomia que as pessoas idosas residentes da Instituição enfrentam diante às novas condições vivenciadas no quotidiano institucional ocasionado pela doença, o que interfere na qualidade de vida destes residentes

Importation and early local transmission of COVID-19 in Brazil, 2020

We conducted the genome sequencing and analysis of the first confirmed COVID-19 infections in Brazil. Rapid sequencing coupled with phylogenetic analyses in the context of travel history corroborate multiple independent importations from Italy and local spread during the initial stage of COVID-19 transmission in Brazil

Genomics and epidemiology of the P.1 SARS-CoV-2 lineage in Manaus, Brazil

Cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in Manaus, Brazil, resurged in late 2020 despite previously high levels of infection. Genome sequencing of viruses sampled in Manaus between November 2020 and January 2021 revealed the emergence and circulation of a novel SARS-CoV-2 variant of concern. Lineage P.1 acquired 17 mutations, including a trio in the spike protein (K417T, E484K, and N501Y) associated with increased binding to the human ACE2 (angiotensin-converting enzyme 2) receptor. Molecular clock analysis shows that P.1 emergence occurred around mid-November 2020 and was preceded by a period of faster molecular evolution. Using a two-category dynamical model that integrates genomic and mortality data, we estimate that P.1 may be 1.7- to 2.4-fold more transmissible and that previous (non-P.1) infection provides 54 to 79% of the protection against infection with P.1 that it provides against non-P.1 lineages. Enhanced global genomic surveillance of variants of concern, which may exhibit increased transmissibility and/or immune evasion, is critical to accelerate pandemic responsiveness

Erratum: Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017

Interpretation: By quantifying levels and trends in exposures to risk factors and the resulting disease burden, this assessment offers insight into where past policy and programme efforts might have been successful and highlights current priorities for public health action. Decreases in behavioural, environmental, and occupational risks have largely offset the effects of population growth and ageing, in relation to trends in absolute burden. Conversely, the combination of increasing metabolic risks and population ageing will probably continue to drive the increasing trends in non-communicable diseases at the global level, which presents both a public health challenge and opportunity. We see considerable spatiotemporal heterogeneity in levels of risk exposure and risk-attributable burden. Although levels of development underlie some of this heterogeneity, O/E ratios show risks for which countries are overperforming or underperforming relative to their level of development. As such, these ratios provide a benchmarking tool to help to focus local decision making. Our findings reinforce the importance of both risk exposure monitoring and epidemiological research to assess causal connections between risks and health outcomes, and they highlight the usefulness of the GBD study in synthesising data to draw comprehensive and robust conclusions that help to inform good policy and strategic health planning

COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P < 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men

Global, regional, and national age-sex-specific mortality and life expectancy, 1950–2017: a systematic analysis for the Global Burden of Disease Study 2017

© 2018 The Author(s). Background: Assessments of age-specifc mortality and life expectancy have been done by the UN Population Division, Department of Economics and Social Afairs (UNPOP), the United States Census Bureau, WHO, and as part of previous iterations of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD). Previous iterations of the GBD used population estimates from UNPOP, which were not derived in a way that was internally consistent with the estimates of the numbers of deaths in the GBD. The present iteration of the GBD, GBD 2017, improves on previous assessments and provides timely estimates of the mortality experience of populations globally. Methods: The GBD uses all available data to produce estimates of mortality rates between 1950 and 2017 for 23 age groups, both sexes, and 918 locations, including 195 countries and territories and subnational locations for 16 countries. Data used include vital registration systems, sample registration systems, household surveys (complete birth histories, summary birth histories, sibling histories), censuses (summary birth histories, household deaths), and Demographic Surveillance Sites. In total, this analysis used 8259 data sources. Estimates of the probability of death between birth and the age of 5 years and between ages 15 and 60 years are generated and then input into a model life table system to produce complete life tables for all locations and years. Fatal discontinuities and mortality due to HIV/AIDS are analysed separately and then incorporated into the estimation. We analyse the relationship between age-specifc mortality and development status using the Socio-demographic Index, a composite measure based on fertility under the age of 25 years, education, and income. There are four main methodological improvements in GBD 2017 compared with GBD 2016: 622 additional data sources have been incorporated; new estimates of population, generated by the GBD study, are used; statistical methods used in diferent components of the analysis have been further standardised and improved; and the analysis has been extended backwards in time by two decades to start in 1950. Findings: Globally, 18·7% (95% uncertainty interval 18·4-19·0) of deaths were registered in 1950 and that proportion has been steadily increasing since, with 58·8% (58·2-59·3) of all deaths being registered in 2015. At the global level, between 1950 and 2017, life expectancy increased from 48·1 years (46·5-49·6) to 70·5 years (70·1-70·8) for men and from 52·9 years (51·7-54·0) to 75·6 years (75·3-75·9) for women. Despite this overall progress, there remains substantial variation in life expectancy at birth in 2017, which ranges from 49·1 years (46·5-51·7) for men in the Central African Republic to 87·6 years (86·9-88·1) among women in Singapore. The greatest progress across age groups was for children younger than 5 years; under-5 mortality dropped from 216·0 deaths (196·3-238·1) per 1000 livebirths in 1950 to 38·9 deaths (35·6-42·83) per 1000 livebirths in 2017, with huge reductions across countries. Nevertheless, there were still 5·4 million (5·2-5·6) deaths among children younger than 5 years in the world in 2017. Progress has been less pronounced and more variable for adults, especially for adult males, who had stagnant or increasing mortality rates in several countries. The gap between male and female life expectancy between 1950 and 2017, while relatively stable at the global level, shows distinctive patterns across super-regions and has consistently been the largest in central Europe, eastern Europe, and central Asia, and smallest in south Asia. Performance was also variable across countries and time in observed mortality rates compared with those expected on the basis of development. Interpretation: This analysis of age-sex-specifc mortality shows that there are remarkably complex patterns in population mortality across countries. The fndings of this study highlight global successes, such as the large decline in under-5 mortality, which refects signifcant local, national, and global commitment and investment over several decades. However, they also bring attention to mortality patterns that are a cause for concern, particularly among adult men and, to a lesser extent, women, whose mortality rates have stagnated in many countries over the time period of this study, and in some cases are increasing